Abstract
Postpartum depression (PPD) is a serious pubic health concern and known to have the adverse effects on mother’s perinatal wellbeing; and child’s physical and cognitive development. There were limited literatures on PPD in Bangladesh, especially in urban slum context. The aim of this study was to assess the burden and risk factors of PPD among the urban slum women. A cross-sectional study was conducted between November-December 2017 in three urban slums on 376 women within first 12 months of postpartum. A validated Bangla version of Edinburgh Postnatal Depression Scale was used to measure the depression status. Respondent’s socio-economic characteristics and other risk factors were collected with structured validated questionaire by trained interviewers. Unadjusted Prevalence Ratio (PR) and Adjusted Prevalence Ratio (APR) were estimated with Generalized Linear Model (GLM) and Generalized Estimating Equation (GEE) respectively to identify the risk factors of PPD. The prevalence of PPD was 39.4% within first 12 months following the child birth. Job involvement after child delivery (APR = 1.9, 95% CI = 1.1, 3.3), job loss due to pregnancy (APR = 1.5, 95% CI = 1.0, 2.1), history of miscarriage or still birth or child death (APR = 1.4, 95% CI = 1.0, 2.0), unintended pregnancy (APR = 1.8, 95% CI = 1.3, 2.5), management of delivery cost by borrowing, selling or mortgaging assets (APR = 1.3, 95% CI = 0.9, 1.9), depressive symptom during pregnancy (APR = 2.5, 95% CI = 1.7, 3.8) and intimate partner violence (APR = 2.0, 95% CI = 1.2, 3.3), were identified as risk factors. PPD was not associated with poverty, mother in law and any child related factors. The burden of postpartum depression was high in the urban slum of Bangladesh. Maternal mental health services should be integrated with existing maternal health services. Research is required for the innovation of effective, low cost and culturally appropriate PPD case management and preventive intervention in urban slum of Bangladesh.
Highlights
Postpartum depression (PPD) is a common, non-psychotic mood or mental disorder which typically manifests in mothers within one year of delivery [1, 2]
7.7% of mothers were working after delivering their child, but before their most recent pregnancy around 49.7% of mothers had been engaged in income generating activities
Among the respondents employed before pregnancy, 54.6% were garments or industry workers, 27.3% were part-time house maid; whereas, 10.7% worked in private and other non-government organization and 7.0% involved some sort of home based work (Tailoring, handicraft, etc)
Summary
Postpartum depression (PPD) is a common, non-psychotic mood or mental disorder which typically manifests in mothers within one year of delivery (first year postpartum) [1, 2]. The prevalence of PPD among mothers ranges from 0.5% to 60.8% [2]. A systematic review of 28 developed countries reported that the prevalence PPD symptom (PPDS) was 6–13% among women in high income nations [4]. An independent systematic review on low and middle income countries (LMIC) found the prevalence of postpartum common mental disorder was approximately 20% [5]. Asian countries reported between 3.5– 63.3% prevalence rates of depression in postpartum women [6]. Several studies conducted in rural Bangladesh found the prevalence of PPD ranged from 18% to 35% among rural women [8,9,10]
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